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Most of the fitness clients I work with want better posture, movement, and performance.   Most of the physical therapy patients I work with want their pain to go away and never come back.  Almost everyone has heard that having strong abdominal muscles is a good thing.  Many well-intentioned fitness enthusiasts injure their lower backs and ruin their posture with improper abdominal exercise activities.  A simple exercise that fixes all of these problems is the Bird Dog.

Bird Dogs Build Core Coordination

The spinal column is controlled by a cylinder of muscles made up of the abdominal muscles in the front and sides, the lumbar muscles in the back, the pelvic floor on the bottom, and the respiratory muscle (diaphragm) on the top.  These muscles never work in isolation.  They function as part of a coordinated team to transfer forces and create joint stability.  Core coordination is essential for better movement and pain-free living.

Bird Dogs Reverse Spine Muscle Atrophy

Each lumbar vertebrae is covered by layers of interwoven muscles that travel in multiple directions.  Ultrasound imaging of the muscles around an injured spinal segment- dx sprain, bulge, post-surgery, slipped disc, lumbago, etc.—reveal that atrophy (shrinkage) of the muscles can set in fairly quickly.  Long after the pain has resolved, the atrophy will persist unless some sort of rehabilitative training is performed.  Bird dogs build these atrophied muscles back to normal size and strength.

Bird Dogs Help You Move

Every time you exercise, your neural system uploads motor control patterns that, for better or worse, alter how you move.  Save good patterns and you move better, save bad patterns and you move worse.   The Bird Dog exercise reinforces the opposite shoulder to hip connection through a stable and resilient spine.  We need this pattern of movement to successfully throw a punch, toss a ball, and save us from a fall.

“But I Don’t Feel The Burn.” 

This is the statement I often get from the patient laying on the treatment table with back pain.  They are reluctant to abandon the traditional sit ups, crunches, and various versions of disk herniating spinal flexion exercises that have helped them return to physical therapy.  I don’t believe the sensations that occur with fifty crunches are the abdominal muscles singing.  I think the abdominal muscles are screaming “Where are my teammates?” and “Would you please stop?”   

Bird Dog Performance

Set up in a quadruped position, the hands under the shoulders and the knees under the hips.  Your fingers are facing forward and the elbows are slightly flexed.  It is important to keep your neck in line with your body– do not look down towards your chest or up towards the ceiling.  Brace the abdominal muscles and hold your back stationary.  Lift the right arm into the air to a point 45° off the midline of the body.  Make sure to lead with the thumb.  Extend the left leg backward by hinging at the hip.  Push out through the heel of the foot and do not let the hip rotate outward.  Keep the body stable and hold this position for 5 seconds.  Now perform the same motion with the left arm and right leg.

Start with five repetitions of five seconds on each side and gradually ramp up the duration of the holds to ten seconds.  As ten second holds become easy, add a resistance band to the exercise.  Before adding duration or resistance to the bird dog, become more graceful and steady through the exercise.  Program two or three sets of the Bird Dog into your training sessions.

Be mindful of your performance of the Bird Dog.  Pay attention to how your body moves and feels during the exercise.  Use a mirror to monitor the position of your spine.  The lower back should stay still as the arms and legs move.  The body should not rotate or wobble.  Do not point the toes- keep the ankle dorsiflexed and push out with the heel by actively contracting the gluteals and hamstrings.  As you get better at the exercise, you should feel a better connection of the shoulder girdle to the torso and hips to the pelvis.

Mastery of the Bird Dog takes time.  Work on this exercise for six weeks and I believe you will be surprised by the changes in pain and movement capacity.

To view video demonstration of the Bird Dog, click on the link below:

 https://www.youtube.com/watch?v=sq05Uhzba90&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

We all want fitness results, and we want them now.  We want to look, move, and feel better in two weeks.  We know it took us years to get into this overweight, weak, and deconditioned state, but we have a wedding in three months, a reunion in six weeks, and a date next Friday.

Unfortunately, many of the physical problems that slow our progress toward specific fitness goals will not resolve with two or three exercise sessions a week.  Postural deficits, faulty motor control, mobility limitations, and joint restrictions require daily attention to elicit any meaningful change.  Short bouts of focused training, interspersed throughout the day, will produce the best results.  In physical therapy rehabilitation, we prescribe home exercise programs that are performed up to every two hours to reduce pain and restore function.  Fitness clients will more rapidly reach their goals with some daily Nano Sessions of exercise.

Nano Office Session

A rounded shoulder, forward bending thoracic spine posture is delivered free of charge with your new smart phone.  This posture has become nearly universal, and it brings with it a gigabyte of shoulder, neck, and head pain problems.  Fitness training at the gym often feeds into this postural problem- sit ups, crunches, spin bike, heavy bench texting, etc…  Combine this with an eight hour office day of computer entry and number crunching and you create a postural deterioration feedback loop that needs a killer app.  This Nano Training session can help.

You will need a resistance band or tubing and a doorway.  It takes daily training to eliminate postural deficits.  Perform this program twice a day. Two or three gym workouts a week are not enough.  I understand you can set an alarm on your smart phone as a reminder that it is time to stand up and move through your Nano Session.

Doorway Stretchoffice_nano

Office workers perform so many tasks with the arms forward and head down that they develop restrictions in the muscles in the front part of the shoulders and chest.  Use a doorway stretch to reverse this adaptive shortening.  Stand up with the elbows placed just below shoulder level against the doorjamb.   Step one foot forward through a doorway.  Hold a gentle stretch for ten seconds and then lower the arms and rest.  Perform two or three ten second stretches.

The stretch should be felt across the front of the shoulders and chest.  Go easy.  Stop at the first point you feel a stretch.  If you are grimacing in agony, then you either have a shoulder problem or you are being too aggressive with the stretch.  As the stretch gets easier, try working the elbows higher up the doorjamb.

Postural Band Aid

One of the most convenient and easy to perform postural correction activities is an exercise I call the postural band aid.  This exercise takes less than thirty seconds to complete and can be performed at any work sight.  Take a short length of tubing or resistance band and stand up.  Assume a tall posture with a proud chest and the head pulled back.  Hold one side of the band in each hand and keep the elbows by the sides.  Pull the band apart so that your arms form a letter W with your body.  You should feel a tightening of the muscle between your shoulder blades.  Hold the band apart for three counts and then slowly release back to the starting position.  Repeat for eight to ten repetitions.

To view video demonstration of the above exercises, click on the link below:

https://www.youtube.com/watch?v=RmUoUKzPr9k&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

Posture correction is a war, and you must fight the battle every day.  You need to frequently awaken the dormant scapula and spinal muscles that hold you in a proper tight and tall posture.  You cannot undo the adaptive shortening and weakness that is created by eight hours a day of gaming, computer working, texting, and driving with two or three exercise sessions a week.  To make a lasting change in posture, you need to fight back with several exercise bouts a day.POSTURALBANDAID

One of the most convenient and easy to perform postural correction activities is an exercise I call the postural band aid.  The exercise takes less than thirty seconds to complete and can be performed at any work sight.  Take a short length of therapy resistance band and stand up.  Assume a tall posture with a proud chest and the head pulled back.  Hold one side of the band in each hand and keep the elbows by the sides.  Pull the band apart so that your arms form a letter W with your body.  You should feel a tightening of the muscle between your shoulder blades.  Hold the band apart for three counts and then slowly release back to the starting position.  Repeat for eight to ten repetitions.  Perform this exercise three or four times throughout your workday.

To view video demonstration of this quick, effective exercise, click on the link below:

https://www.youtube.com/watch?v=n5iRnH_AUTI&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

For the last two years, Janet had been “bothered” by lower back and hip pain.  When the symptoms made walking and getting out of bed difficult, she sought medical attention.  Janet had X-rays and Magnetic Resonance Imaging of her lumbar spine that showed she had some arthritis and stenosis in her lower back.  She, then, underwent ablation of nerves in her lumbar spine and injections into her sacroiliac joints.  These treatments decreased the pain in the lower back, but pain in the left hip and sacral region persisted.  Three months after her last injections, Janet was referred for physical therapy.

On her initial physical therapy evaluation, Janet had none of the pain that caused her to seek medical attention.  She stated the pain was present in the morning and with prolonged standing.  She could stand for no more than ten minutes when the pain would become so intense she had to sit down.  Sitting for fifteen to twenty minutes would resolve her pain.  Janet had good spinal mobility, excellent hip range of motion, and normal strength in both legs.  Her core stability was limited to a poor grade, but otherwise, she passed all functional tests.  On further questioning about her lifestyle and activities, Janet failed a big test.

Physical Therapist:  What do you do for exercise?shutterstock_135632903

Janet:  I walk on a treadmill every day.

Physical Therapist:  How long do you walk?

Janet:  One or two miles.

Physical Therapist:  I thought standing caused you to have pain?

Janet:  I do not have pain if I hold onto the rails.

Treatment:  Stop walking on the treadmill.

Janet was skeptical.  After all, walking was good exercise, and she wasn’t in pain if she held the rails.  How could something good for you perpetuate the pain?  Janet, however,  was willing to try anything to get rid of her pain, so she agreed to a one week break from the treadmill.  Ten days later Janet was pain- free.

When you walk on a treadmill you perform 2,000-2,500 step repetitions per mile.  With every step taken, you must decelerate and then accelerate one and a half to two times your body weight.  Holding onto the rails or the console of the treadmill can easily add 10-15% more load through your spine and pelvis.  A woman who weighs 135 pounds walks with a fifteen pound weight vest on her back when she holds onto the treadmill.  Torso and pelvic girdle rotation is a key component of normal locomotion–watch any speed walker.  Holding onto the rails restricts the free flowing, rotational component of gait.  Thousands of repetitions of a restricted gait pattern, with extra load, performed on a daily basis, can create lots of pain problems.

Treadmill gripping is a common driver of pain problems.  As is often the case, the pain is not experienced during the treadmill exercise session, so the patient does not connect the activity with the symptoms.  Patients with head, neck, lower back, and leg pain symptoms often have this same well-intentioned exercise habit.

-Michael O’Hara, P.T., OCS, CSCS

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